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Individual

PAULA J WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2615 E RANDOLPH AVE, ENID, OK 73701-4670
(580) 234-3734
(580) 234-3554
Mailing address
2615 E RANDOLPH AVE, ENID, OK 73701-4670
(580) 234-3734
(580) 234-3554

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2571
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100653300B
OK
Enumeration date
05/15/2008
Last updated
05/15/2008
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